When You Least Expect It
by Zana Zira
Summary: Season 1, after "Dead in the Water": Dean's always been a healthy guy, despite all the junk he eats and filth he's exposed to. So when he gets a little sick after the Lake Manitoc case, he doesn't think anything of it until it's almost too late, and the diagnosis he's given is something he never expected to hear. Sick/Diabetic!Dean, Caring!Sam. Written for a DeviantArt prompt. Gen.


**Disclaimer: Supernatural and its characters are the property of Eric Kripke. Sadly, I do not own any of these guys.**

**A/N: This fic was requested by one of my most loyal readers on DeviantArt, who requested diabetic!Dean set in one of the earlier seasons. I hope you all enjoy it, since this was an area of sick-fics I've never ventured into before. ;)**

* * *

It had been a long time since the conclusion of a hunt had left Dean feeling this happy, the hunter mused as he drove and munched on one of the sandwiches Lucas and Andrea Barr had made for them. In the weeks before Sam left for Stanford, every hunt with his father and brother had only reminded him of how much Sam was starting to resent John, and even Dean for keeping him where he hated to be.

The search for the Woman in White had ended with the death of the woman his little brother had loved more than life, so it definitely hadn't helped him enjoy coming back to Dean's side. The older Winchester didn't blame him, either; even though he'd wanted Sam to come back ever since the day he left, Dean would never in a million years have wished for the circumstances that brought him there. And although they'd managed to save one of the missing people during last week's Wendigo hunt, it had nearly cost Dean his life and put even more stress on an already grieving Sam, so he didn't consider that to be one of his greatest hits either.

So all in all, this vengeful spirit at Lake Manitoc had been the most successful – and least painful – hunt he and Sam had completed in the last month. It hadn't taken them long to get changed into some dry clothes (because diving into a lake in the middle of winter was freaking suicidal) and pack up their room before setting off for the open road again.

Now Sam was asleep, hunched down into the warmth of his favorite hoodie and snoring softly as the Impala rumbled down the mostly empty highway out of Wisconsin. Dean smiled when he noticed some crumbs from one of the sandwiches decorating Sam's hoodie around the neck and shoulders; his little bro must have really been hungry to make a mess of himself like that. He chuckled softly, and then winced when he felt something twinge in his belly.

"Huh," he muttered to himself when it passed as soon as it had come. "Musta pulled something diving into the lake." He didn't think anything more of it, finishing another few small sandwiches and two bottles of water in under an hour while he drove along under the gloomy, overcast sky. He sang along softly to the music playing from his cassettes, quieting down whenever Sam stirred before picking back up again a moment later.

Thirty minutes had gone by when Dean's bladder started to complain at him, but it wasn't enough to get his attention at first. He barely even noticed how badly he needed a bathroom until he was practically squirming in his seat, and then all of a sudden he realized drinking so much water while being in the car had probably not been his greatest idea. Why he hadn't remembered that sooner, he had no idea, because he'd been drinking water like it was going out of style for the past two days. In only another minute or two, the feeling had reached unbearable levels, and he hurriedly pulled off the side of the road and stepped behind the car to – ahem – water the grass.

Careful not to wake Sam – 'cause, y'know, awkward – he hurriedly finished up and had started making his way back around the car when he suddenly stumbled, holding his head as a wave of dizziness threatened to send him to his knees. Nausea flared up in his gut, making his mouth water as he swallowed hard against the urge to throw up, and it took a long time before the feeling passed and he was able to stand up straight without swaying again.

"_Okay, that was weird_," he thought to himself. He'd been feeling fine just a minute ago, so why did he suddenly feel so tired and sick? Sure, he'd jumped into a freezing lake earlier that day, but so had Sam, and he was fine. Besides, the worst water would cause him was a chill or maybe pneumonia, and he didn't feel feverish or fluey at all. No, this was probably something else.

He sat down in the driver's seat and peered over at the sandwiches, suddenly having to close his eyes and turn his head at the mere sight of them. His stomach twinged again, and this time it was bad enough to make him gasp and bring a hand to his belly to try to ease the ache. Hmm, maybe eating the food that had been sitting out in the car all day hadn't been the brightest plan either. He'd started eating them later than Sam had, and they had meat and mayo on them, so… Yeah, that was probably it.

Either way, he was starting to feel worse by the minute. Time to find a motel where he could sleep this off before it got bad.

* * *

Sam awoke when the Impala started pulling to a stop, feeling pretty refreshed after a few hours' sleep. Once he'd gotten his bearings, though, he blinked in confusion, staring up at the still-bright sky and then at his brother, who was already taking the keys out of the ignition and getting ready to step out into this motel's parking lot.

"Dean? What's up? Why are we stopping?"

Dean sighed and then turned to look at Sam. He seemed pale and a little sweaty, but Sam might just have been imagining it.

"I'm just… not feelin' so hot all of a sudden," Dean said with an embarrassed shrug, not meeting Sam's eyes and grimacing when his queasy stomach rolled a little more. "Not sure if it was the sandwiches or what, but my stomach's kinda testy, and I just thought maybe we ought to stop for today and rest a little."

"Oh. Yeah, okay," Sam said quietly, accepting that answer but feeling like there was something Dean hadn't told him.

He and his brother had grown up eating at all kinds of less-than-reputable places, and he could count on one hand the number of times he remembered Dean actually being sick enough to voluntarily choose a motel instead of the car during the day. Usually he just suffered in silence, either staying in the driver's seat or, if it was bad enough, riding shotgun so they could pull over for him if needed. Some sandwiches that had been left out for a few hours definitely wouldn't be enough to turn Dean's stomach so easily.

Sam didn't even bother to call him on it though; if Dean was sick enough to need his help, he'd know when _Dean_ was ready to tell him, and not a moment sooner. He just hoped his brother wasn't hiding anything important from him.

The moment Dean stepped inside their hastily-rented room, he immediately collapsed onto the bed, shuffling around under the covers until he felt fairly comfortable and then sinking into the mattress with a soft sigh. For some reason, he really wasn't feeling well all of a sudden. His stomach was starting to cramp almost constantly, he felt even more nauseous than he had an hour before, and he was so tired he wasn't even sure he could make it out of the bed to the bathroom if he needed to. There didn't seem to be any reasonable explanation for these symptoms except for some kind of flu, and he really hoped that wasn't it because then Sam would get it too, and the kid always got ten times sicker than Dean every time they ended up sharing a bug.

When he heard Sam come in with their bags he closed his eyes, trying to feign sleep and hoping his brother would leave him alone because he really didn't feel like being hovered over right now.

Unfortunately for him, though, that's exactly what Sam seemed to want to do. He felt the mattress dip down beside him, and then flinched when Sam's enormous chilly hand was placed across his forehead.

"Dean? How are you feeling?" he asked quietly, and Dean sighed, feeling like total crap but not willing to admit to that just yet. Not if he could help it, anyway; that was starting to feel like less and less of a possibility the more nauseous he became.

"I'm fine, Sam," he said in what he hoped was a steady voice, trying to get his worrywart brother to leave him to his misery. "Just need to sleep it off and then I –" He suddenly stopped and swallowed hard, feeling the queasiness ratchet up to an eleven out of ten. "S-Sam…"

A trashcan appeared in front of his chin a millisecond before he started retching, and he held onto it with a death-grip, trying to ride out the agony that was suddenly ripping through his midsection with every heave. He must have made some kind of pained noise, because a moment later he felt Sam's hand on the back of his neck, a silent reassurance that his brother was there to do whatever he needed.

"Easy, Dean," Sam muttered close to his ear when he choked on a gag and spluttered helplessly over the bin. "You're okay, just give it a minute."

Sam was right, of course, and within another minute or two the heaves tapered off, leaving Dean shaking and out of breath when he finally handed the can off for Sam to rinse out. But even after Sam had finished cleaning it and come back, he was still fighting for air like he'd just run a marathon, and as thirsty as if he'd run one too. What in the hell was this? Stomach bugs were supposed to make him tired, sure, but being out of breath and dying of thirst after one bout of puking was a new one.

"Are you okay now?" Sam asked when he'd placed the clean bin beside Dean's bed and sat down on his own.

Dean just nodded and grunted an affirmative, sinking into the blankets again and hoping he'd feel better when he woke up. The last thing he heard before dropping off into sleep was Sam getting situated on the other bed, likely preparing to do some research for another case. An instant later, though, he was dead to the world, leaving Sam alone with only his books for company.

The rest of the evening and night were spent in a constant whirl of chaos. Dean couldn't seem to hold down even water for a very long period of time after he drank it, and it seemed like every time Sam finally got him settled down in bed again, he would be leaning over the side and retching into the tiny motel trashcan only minutes later. That meant Sam spent a good portion of the night either coaxing crackers and fluids into his brother, holding him up while he puked, or cleaning up after him the few times he hadn't been able to hit the bin.

Dean also seemed to be running a little bit of a fever, and even though he was still getting up to stumble into the bathroom and pee every few hours, he wasn't sweating at all. It definitely wasn't good to be losing so many fluids at once, and try as Sam might, he just couldn't seem to keep ahead of it. For every ounce of liquid he persuaded Dean to drink, his brother seemed to lose two more, and it was definitely starting to take a toll on his body.

Sam was really starting to get worried that this was more than just food poisoning when it hadn't stopped by sunrise the next day. Dean seemed to be getting weaker by the minute, and he was curled up in a ball constantly now as his stomach muscles cramped and tormented him even when he wasn't vomiting. He hadn't been able to convince him to eat anything all night, and now even water seemed to have lost its appeal. But his older brother had been sleeping peacefully for the last couple of hours, and hadn't been sick to his stomach that entire time, so Sam decided then and there to wake him up and see if he could coax some broth into him. If not, the very next step would be the hospital.

"Dean?" he asked softly, crossing the room with a cup of warm chicken broth and a few crackers in hand and setting them on the nightstand beside his brother's bed. "Come on, man, wake up. It's breakfast time."

When there was absolutely no response from the other Winchester, he tried again, this time speaking louder while he shook Dean's shoulder.

"Dean? Come on, wake up."

Still nothing, and Sam's heart began to race when he realized how sunken and bruised his brother's eye sockets were starting to look, and how deep and rapid his breathing was. He leaned a little closer, and when he did he realized that instead of smelling sour and stale after a night of being ill, Dean's breath smelled sickly sweet, almost like acetone. But how could that be? He hadn't even eaten any sweets.

"Oh, shit," Sam muttered when the answer hit him a moment later.

Now it was all starting to make sense. Jess had been pre-med, and during a late-night study session for one of her classes she'd once told him that all of these symptoms – deep, quick breaths, fever, vomiting, and dehydration with excessive urination and thirst – were indicators of extremely high blood sugar levels in someone with diabetes. Dean wasn't a diabetic, at least as far as he knew, but there were few other things that put all those symptoms together with an acetone smell to the breath.

Way out of his league with this one, Sam was left with no other option than to call 911.

* * *

The doctors at the hospital later informed Sam that he had made the right decision in calling the paramedics. When Dean had arrived at the hospital and the doctors were informed of his symptoms, they immediately tested his blood for ketones and looked at the sugar levels, and both results were scarily high. His oxygen levels were also only ninety percent and dropping, thanks to the excess CO2 being pumped through his body. Had Sam not brought him sooner, they said, he would have been at risk for slipping into a coma.

They immediately dosed him with a shot of insulin, and over the next several hours his condition steadily improved, until he was able to wake up and speak coherently with Sam for the first time all day. After that, it was all a flurry of tests and lab results, different doctors and pamphlets and explanation after explanation, until it made both their heads spin. Dean had to spend several days in the hospital while they got his blood sugar controlled, and then he was sent home with a small kit containing needles, a blood glucose meter, testing strips, insulin, and sugar supplements in case of emergency.

It turned out that Dean had Type I diabetes, which Sam hadn't known could occur after early childhood but apparently was fairly commonly diagnosed in teens and young adults as well. It was completely spontaneous, too, so unlike Type II which was caused by an unhealthy diet and lack of exercise, they would have had no way to see this coming. His was unfortunately already severe, meaning he would require multiple insulin shots daily to maintain a healthy blood sugar and constant monitoring with a handheld meter to make sure his levels were acceptable. He also had to make sure to try and eat healthier, which Sam resolved to help him with since he'd never really had any interest in anything remotely healthy.

And, just in case Dean should ever lose his meter for some reason, the doctors also taught both of them a general rule of thumb to tell if something was wrong with his sugar levels: _"Cold and clammy, need some candy; hot and dry, sugar high."_ Neither of those things should happen if Dean kept his sugar where it needed to be, but it was a good way to know when he was in real trouble.

Dean took the news fairly well, considering how much of a blow it was to his ego and his reputation of being one of the healthiest people he knew. He did sulk at first about having to take medicine every day, saying it made him feel like an invalid, but when Sam pointed out that the alternative was being constantly weak and sick and eventually even losing his limbs or sight, he quit whining very quickly. By the end of the first week, Sam didn't even have to remind him to check his sugar after meals anymore, or how to calculate the units of insulin he needed based on how much his sugar was off from ideal.

They had a few hiccups, of course, and Sam had to force sugar supplement gel into his brother on more than one occasion after it got too low and he passed out, but all in all it didn't affect either of their lives too much. Dean was still his usual obnoxious self, pretending to be annoyed with Sam's attention to his health because gratitude just wasn't cool enough. He still resisted the health food as much as he could too, and tried shoving the extra veggies onto Sam's plate whenever he wasn't looking.

But what Dean didn't know was that no matter how much he claimed to have it all under control, Sam always kept a spare monitor kit in his duffel bag, and another bottle of insulin in the cooler. Just in case something ever happened to make Dean neglect his health, Sam wanted to be able to pick up the slack. After all, these things always seemed to strike when they were least expected, and he'd lost enough people he loved to last him a lifetime. And if he had anything to say about it, that was never going to happen again.


End file.
